The Thai Life Insurance Association (TLIA) is currently trying to talk to the Office of the Insurance Commission (OIC) about curbing growing health insurance claims.
Specifically, the TLIA wishes to discuss setting out the criteria at different levels of health insurance loss ratios for adjusting individual health insurance premiums, reported the news website Prachachat.net, quoting Mrs Nusara Banyatpiyaphod, managing director and CEO of Thai Ocean Life Insurance.
She indicates that medical expenses in Thailand have been increasing every year at a rate of 7-17%.
In addition, the life insurance business sector faces a high level of claims for common minor illnesses, as well as the problem of insurance fraud or moral hazard.
Co-payment
Mr Sara Lamsam, CEO of Muang Thai Life Assurance and vice president of Marketing at the TLIA, says that the association is currently trying to educate the public that health insurance claims should not be excessive and that medical treatment should be sought because of a medical necessity.
The TLIA is also discussing with the OIC whether it would be possible under new health insurance requirements to impose co-payments up to 30% if claims made by an insured person for minor general illnesses were to exceed designated limits, such as the number of times claims are lodged in a policy year. The co-payment measure can be cancelled if the insured person has an improved claim rate.
An alternative proposal is to impose premium hikes on individuals who make excessive claims for common minor illnesses.
Currently, the association, through its medical advisory board, is studying this issue. At the same time, a joint working group has been set together with the Thai General Insurance Association, the OIC, and other relevant agencies.
Mr Sara adds that any life insurance company can implement a co-payment scheme if they submit a request to the OIC. However, no insurance company has applied for it so far.
The TLIA, the Thai General Insurance Association, the OIC, and the Ministry of Public Health have worked together to try to find a way to prevent medical expenses from rising too quickly. These efforts fell through, partly because of medical inflation.